Referral form

Who is referring?

Referrer name

Referring organisation

Referrer email

The household

Name

Phone

Email

Address

Kind of help

Food parcel

Note

How we use your details

Purpose: Contact details of households referred by a social worker, used to review the referral, decide on it and organise the weekly parcel pickup.
Lawful basis: Your consent
How long we keep them: 2 years after the last contact, then deleted

I agree that my details are used for: Contact details of households referred by a social worker, used to review the referral, decide on it and organise the weekly parcel pickup..Required

Who is referring?

The household

How we use your details

Your consent